About
214
Publications
198,913
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
31,129
Citations
Introduction
Additional affiliations
January 1978 - December 2007
Publications
Publications (214)
Previous research has documented the inhibitory effects of worry on cardiovascular reactivity to subsequently presented fear-relevant stimuli. Although theoretical assertions point to the verbal-linguistic (as opposed to imagery-based) nature of worry as the cause of these inhibitory effects, extant research investigating the effects of worrisome t...
Background
Cognitive–behavioural therapy (CBT) is the treatment of choice for generalised anxiety disorder (GAD), yielding significant improvements in approximately 50% of patients. There is significant room for improvement in the outcomes of treatment, especially in recovery.
Aims
We aimed to compare metacognitive therapy (MCT) with the gold stan...
Worry is associated with inflexibility in cognitive, emotional, and physiological functioning. In addition, worry’s negative valence and abstract level of construal are rigid characteristics that contribute to its nonadaptive consequences. Relaxation and cognitive therapy aim to increase flexibility in chronic worriers, and may have greater efficac...
Applied relaxation (AR), originally developed by Lars-Göran Öst, is a long-standing, efficacious treatment for generalized anxiety disorder (GAD). While newer treatments are continuing to be developed, AR remains one of the most efficacious treatments for GAD. However, AR has received less in-depth attention more recently, particularly in terms of...
Consistent with assertions that the adaptiveness of repetitive thinking is influenced by both its valence and style, Stöber (e.g., Stöber & Borkovec, 2002) has argued that worry is characterized by a reduced concreteness of thought content and that the resulting abstractness contributes to its inhibition of some aspects of anxious responding. Howev...
We examined the reliability, validity, and factor structure of the posttraumatic stress diorder (PTSD) Checklist-Civilian Version (PCL-C; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996) among unselected undergraduate students.
Participants were 471 undergraduate students at a large university in the Eastern United States and were not presele...
In a seminal publication, Goldfried (1980) identified a number of principles of change that cut across different forms of psychotherapy, among which was the therapist’s facilitation of corrective experiences (CEs). As with all of the other principles he identified, Goldfried asserted that the types of CEs (and/or the procedures to foster them) are...
Recent models suggest that generalized anxiety disorder (GAD) symptoms may be maintained by emotional processing avoidance and interpersonal problems.
This is the first randomized controlled trial to test directly whether cognitive-behavioral therapy (CBT) could be augmented with the addition of a module targeting interpersonal problems and emotion...
Reports an error in "Psychotherapists, researchers, or both? A qualitative analysis of psychotherapists' experiences in a practice research network" by Louis G. Castonguay, Dana L. Nelson, Mary A. Boutselis, Nancy R. Chiswick, Diana D. Damer, Neal A. Hemmelstein, Jeffrey S. Jackson, Marolyn Morford, Stephen A. Ragusea, J. Gowen Roper, Catherine Spa...
Generalized anxiety disorder (GAD) first appeared as a diagnosis in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association (APA), 1980). Since that time, programmatic research on the nature of worry and GAD has
led to advancements both in its diagnostic criteria and in its treatment...
This paper describes the experiences of psychotherapists who, as part of a practice research network (PRN), collaborated with researchers in designing and conducting a psychotherapy study within their own clinical practices. A qualitative analysis of interviews conducted with these psychotherapists led to the delineation of several benefits (e.g.,...
This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientat...
This article presents a panel discussion on the integration of homework assignments into cognitive behaviour therapy sessions. The panel comprised experts in research and practice who had been invited as keynote presenters for the 32nd National Conference for the Australian Association of Cognitive and Behaviour Therapy. Experts responded to questi...
Generalized Anxiety Disorder (GAD) and excessive worrying are characterized by a preoccupation with the future. Thus, enhanced identification of potential future punishments or omissions of reward may be related to the disorder. To test this hypothesis, n=47 students meeting GAD criteria according to the GADQ-IV (GAD analogues) or not (control part...
The current study examined the impact of comorbidity on cognitive and behavioral therapies for generalized anxiety disorder (GAD) as well as the impact of these therapies on diagnoses comorbid to GAD. Seventy-six treatment-seeking adults with principal diagnoses of GAD received 14 sessions of therapy. Most (n=46; 60.5%) of the sample had at least o...
Generalized anxiety disorder (GAD) has undergone a series of substantial classificatory changes since its first inclusion in DSM-III. The majority of these revisions have been in response to its poor inter-rater reliability and concerns that it may lack diagnostic validity. This article provides options for the revision of the DSM-IV GAD criteria f...
This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientat...
This paper describes the experiences of psychotherapists who, as part of a practice research network (PRN), collaborated with researchers in designing and conducting a psychotherapy study within their own clinical practices. A qualitative analysis of interviews conducted with these psychotherapists led to the delineation of several benefits (e.g.,...
This article presents a panel discussion on the integration of homework assignments into cognitive behaviour therapy sessions. The panel comprised experts in research and practice who had been invited as keynote presenters for the 32nd National Conference for the Australian Association of Cognitive and Behaviour Therapy. Experts responded to questi...
Worry has been associated with adverse mental and somatic health outcomes, which have been attributed to the pathogenic physiological activity caused by worry. However, experimental evidence is scarce, and existing studies did not address whether the physiological effects of worry do actually exceed those of mere mental load during cognitive proble...
Even though generalized anxiety disorder (GAD) is one of the most common of the anxiety disorders, relatively little is known about its precursors. Bowlby's attachment theory provides a framework within which these precursors can be considered. According to Bowlby, adult anxiety may be rooted in childhood experiences that leave a child uncertain of...
The main purpose of the present study was to examine the startle reflex in individuals diagnosed with Generalized Anxiety Disorder (GAD) and control participants in terms of three questions. First, is the basic startle reflex modulated by autonomic nervous system (ANS) activation and/or attentional focus? Second, are induced and self-reported emoti...
Worry has been associated with adverse mental and somatic health outcomes, which have been attributed to the pathogenic physiological activity caused by worry. However, experimental evidence is scarce, and existing studies did not address whether the physiological effects of worry do actually exceed those of mere mental load during cognitive proble...
The current investigation examined self-reported family history of psychological problems in a large sample of individuals diagnosed with generalized anxiety disorder (GAD) and nonanxious controls. The GAD participants were all individuals receiving cognitive-behavioral therapy as part of two large randomized clinical trials. Family history informa...
Cognitive- behavioral therapy (CBT), although effective, has the lowest average effect size for generalized anxiety disorder (GAD), when compared to effect sizes of CBT for other anxiety disorders. Additional basic and applied research suggests that although interpersonal processes and emotional avoidance may be maintaining GAD symptomatology, CBT...
Basic Cognitive Behavioral Interventions for GADAdditional Intervention Methods
Efficacy ResearchNew Therapeutic DevelopmentsConclusion
AcknowledgementReferences
This chapter contains section titled:
The present study examined EEG gamma (35-70 Hz) spectral power distributions during worry inductions in participants suffering from generalized anxiety disorder (GAD) and in control participants without a history of psychiatric illness. As hypothesized, the EEG gamma band was useful for differentiating worry from baseline and relaxation. During wor...
The effects of worry and rumination on affective states and mentation type were examined in an unselected undergraduate sample in Study 1 and in a sample of individuals with high trait worry and rumination, high rumination, and low worry/rumination in Study 2. Participants engaged in worry and rumination inductions, counterbalanced in order across...
Early sessions from three variants of cognitive-behavioral therapy (CBT) were examined to replicate work done in psychodynamic-interpersonal treatments linking interpersonal process to outcome (W. P. Henry, T. E. Schacht, & H. H. Strupp, 1986, 1990). Cases were available from a component study of CBT for generalized anxiety disorder (T. D. Borkovec...
Due to the numerous conceptual, methodological, and ethical problems that are associated with placebo conditions in psychotherapy research, their use should be abandoned, and more powerful therapy outcome designs (dismantling, additive, parametric, and catalytic) that can contribute to basic knowledge through their ability to isolate specific cause...
Several investigations have examined the potential role of mentation suppression in various psychological disorders. Existing studies do not, however, differentiate between the effects of suppressing imagery- versus thought-based mentation. This distinction is an especially important one for worry, given the predominantly thought-based nature of th...
The present study examined the frequency with which participants experienced thoughts and images, as well as relaxed, anxious, and depressed affect, when worrying and when recalling past traumatic events. Unselected participants in Study 1, and participants selected on the basis of their GAD and past trauma status in Study 2, engaged in 5-minute co...
Chapter 11 discusses cognitive-behavioral assimilative integration, and how the beneficial use of what many would consider non-cognitive-behavioral therapy (non-CBT) methods has raised the question of how best to incorporate methods derived from (or consistent with) humanistic, psychodynamic, interpersonal, or systemic approaches into CBT practice....
The beneficial use of what many would consider non-cognitive-behavioral therapy (non- CBT) methods has raised the question of how best to incorporate methods derived from (or consistent with) humanistic, psychodynamic, interpersonal, or systemic approaches into our CBT practice. The integrative approach described in this chapter represents our effo...
Recent research has revealed that a large number of highly worried individuals do not qualify for a diagnosis of generalized anxiety disorder (GAD). This raises the intriguing question of why some high worriers are more impaired and distressed by their worrying than others, particularly when the severity of their worry is the same. The present inve...
The conceptual and methodological framework proposed by Doss (this issue) (see record 2004-20381-004) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/dismantling studies. We also suggest research topics and m...
In this study, we examined the relationship between treatment outcome and variables from the Inventory of Interpersonal Problems Circumplex scales (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in the Pennsylvania Psychological Association's Practice Research Network (PRN; Borkovec, Echemendia, Ragusea, & Ruiz, 2001). The PRN was a naturalistic...
This edited 2004 collection is a tribute to Andrew Mathews, distinguished researcher in cognition and emotion. It presents an account of the cognitive-clinical literature and sets an agenda for future work. The book is structured around theoretical, empirical and clinical approaches. Theoretical topics covered include learning theory, attentional p...
Wells (Behav. Cogn. Psychother. 23 (1995) 301) proposed a cognitive model, which distinguishes between two kinds of worry: type I worry (focused on external things) and type II worry or metaworry (worry about one's own thoughts and worry). Wells' model assigns a central role to metaworry in the development of excessive worry, and Wells and Carter (...
The current study investigated whether generalized anxiety disorder (GAD) individuals rely on antecedent information to interpret ambiguity and whether reliance on such preceding cues persists in the absence of potential threat. Twenty-six GAD and 23 nonanxious control college students performed a lexical decision task, using homographs (i.e. words...
The present commentary encourages the development of research infrastructures within the training clinics of clinical psychology programs, the use of such infrastructures for creating a true integration of science and practice in the earliest days of graduate student education, and the formation of collaborative practice research networks among cli...
The conceptual and methodological framework proposed by Doss (this issue) makes valuable suggestions for strategic choices in future research. This commentary addresses conceptual and terminological distinctions adopted by Doss, as well as his criticism of add-on/ dismantling studies. We also suggest research topics and methodological developments...
Understanding generalized anxiety disorder (GAD) and developing interventions for its amelioration could contribute significantly to the understanding and treatment of all adult emotional disorders. GAD has a fairly high prevalence rate, is often associated with multiple additional Axis I diagnoses, and is a frequent comorbid condition for other an...
Psychotherapy integration has become a dominant movement (Castonguay, Reid, Halperin, & Goldfried, 2003). Convinced that "pure-form" orientations have neither provided a satisfactory understanding of psychopathology nor resulted in sufficiently effective treatments for the majority of their clients, many psychotherapists have integrated constructs...
After providing background information on the definition and nature of generalized anxiety disorder, this article describes cognitive-behavioral therapy (CBT) methods that have been empirically supported in the treatment of this disorder. Subsequent to this description, relevant outcome literature is briefly reviewed, along with evidence that the a...
After providing background information on. the definition and nature of generalized anxiety disorder, this article describes cognitive-behavioral therapy (CBT) methods that have been empirically supported in the treatment of this disorder. Subsequent to this description, relevant outcome literature is briefly reviewed, along with evidence that the...
Between-group outcome research is a scientific approach to evaluating the effectiveness of psychotherapy and the mechanisms of change associated with those treatments for psychological disorders. This area of research is replete with important methodological issues that need to be considered in order for investigators to draw the strongest, most sp...
The present study examined the usefulness of the Penn State Worry Questionnaire (PSWQ) as a means of screening for generalized anxiety disorder (GAD). Using receiver operating characteristic analyses, the accuracy of the PSWQ in screening for GAD was examined in both clinical and analogue diagnosed GAD samples. Given high comorbidity between GAD an...
Clients with generalized anxiety disorder (GAD) received either (a) applied relaxation and self-control desensitization, (b) cognitive therapy, or (c) a combination of these methods. Treatment resulted in significant improvement in anxiety and depression that was maintained for 2 years. The large majority no longer met diagnostic criteria; a minori...
Roemer and Orsillo have provided an integrative perspective for developing more effective therapies for generalized anxiety disorder, based on existing knowledge about the disorder, cognitive behavioral approaches to its treatment, and conceptualizations and treatment methods from the acceptance/mindfulness tradition. The present commentary expands...
Roemer and Orsillo have provided an integrative perspective for developing more effective therapies for generalized anxiety disorder, based on existing knowledge about the disorder, cognitive behavioral approaches to its treatment, and conceptualizations and treatment methods from the acceptance/mindfulness tradition. The present commentary expands...
Much of the Eye Movement Desensitization and Reprocessing (EMDR) efficacy research has been widely criticized, limiting scientific understanding of its therapeutic components. The present investigation of Eye Movement Desensitization (EMD) effectiveness included undergraduate students reporting current intrusive cognitions conceming a traumatic eve...
A sample of clients diagnosed with generalized anxiety disorder (GAD) provided descriptions of the two major problems they worried about and of potential negative consequences associated with these problems, once before and once after they received cognitive–behavioral therapy. When descriptions were rated for concreteness and compared to those of...
The goal of this chapter is to present an overview of cognitive behavioural therapy (CBT) for generalised anxiety disorder (GAD). The symptomatic picture of GAD is first described. Specific techniques developed by cognitive behaviour therapists to reduce GAD symptoms are then presented. In addition, the empirical evidence supporting the effectivene...
Researchers have described 2 types of worriers, normal and pathological, who differ in the frequency, intensity, and controllability of their worry experiences. Although normal and pathological worry are generally treated as separate though related phenomena, no study has tested for separateness against the alternative hypothesis that all worry exi...
Researchers have described 2 types of worriers, normal and pathological, who differ in the frequency, intensity, and controllability of their worry experiences. Although normal and pathological worry are generally treated as separate though related phenomena, no study has tested for separateness against the alternative hypothesis that all worry exi...
This article describes the development and implementation of the Pennsylvania Practice Research Network for facilitating psychotherapy research in the naturalistic setting. The methods and results from this phase I pilot project provide a basis for discussing the limitations that characterize effectiveness investigations, why they are insufficient...
Recent evidence suggests that a relationship exists between worry, the central feature of generalized anxiety disorder (GAD), and compulsive behaviors, particularly compulsive checking. In this article we report the results from two studies. The first study assessed the frequency of obsessions and compulsions in 107 principally diagnosed GAD client...
Previous research has demonstrated the facilitative effects of relaxation and inhibitory effects of worry on the emotional processing of imaginal fear exposures. The present study was designed to determine whether these same effects occur in the emotional processing of in vivo exposures to feared stimuli. Forty-two speechanxious college students we...
The present article describes the basic therapeutic techniques used in the cognitive-behavioral therapy (CBT) of generalized anxiety disorders and reviews the methodological characteristics and outcomes of 13 controlled clinical trials. The studies in general display rigorous methodology, and their outcomes are quite consistent. CBT has been shown...
To provide primary care clinicians with a better understanding of management issues in generalized anxiety disorder (GAD) and guide clinical practice with recommendations on the appropriate treatment strategy.
The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R.T. Davidson, Yves L...
In a previous study, Borkovec, Abel, and Newman (1995) examined whether successful psychotherapy for principal GAD also targeted comorbid diagnoses. Results showed that successful GAD treatment was associated with a dramatic reduction in comorbid diagnoses when compared to clients for whom the outcome had been ambiguous. The present study examined...
The present article describes the basic therapeutic techniques used in the cognitive-behavioral therapy (CBT) of generalized anxiety disorders and reviews the methodological characteristics and outcomes of 13 controlled clinical trials. The studies in general display rigorous methodology, and their outcomes are quite consistent. CBT has been shown...
Although findings of an implicit memory bias for threat words in generalized anxiety disorder (GAD) are fairly robust, the data regarding an explicit bias in this disorder are less consistent. This issue was investigated in the context of two studies directed primarily at the examination of attentional and physiological underpinnings of GAD. In the...
The present research evaluated the psychometric properties of the credibility/expectancy questionnaire, a quick and easy-to-administer scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. The results suggested that this questionnaire derives the two predicted factors (cognitively based credibility...
The hallmark of generalized anxiety disorder (GAD) is chronic uncontrollable worry. A preattentive bias toward threat cues and hypervigilance may support this ongoing state of apprehension. A study was conducted to bridge the attentional and physiological underpinnings of GAD by examining phasic heart period (HP) responses to cued threat and nonthr...
This article represents a transcribed roundtable discussion on anxiety disorders that took place at the 1998 Society for Psychotherapy Research in Snowbird, Utah. Eminent experts in the field of anxiety disorders took part in a discussion that focused on issues related to theory, basic science, public policy, therapy research, clinical training, an...
The controversial move toward the development of a consensus on evidence-based or empirically supported therapies may be seen as an international crisis facing psychotherapists. Researchers long have complained that practicing therapists all too often continue to guide what they do therapeutically on the basis of their clinical experience and not t...
This article represents a transcribed roundtable discussion on anxiety disorders that took place at the 1998 Society for Psychotherapy Research in Snowbird, Utah. Eminent experts in the field of anxiety disorders took part in a discussion that focused on issues related to theory, basic science, public policy therapy research, clinical training, and...
The controversial move toward the development of a consensus on evidence-based or empirically supported therapies may be seen as an international crisis facing psychotherapists. Researchers long have complained that practicing therapists all too often continue to guide what they do therapeutically on the basis of their clinical experience and not t...
Individuals suffering from generalized anxiety disorder hold a variety of beliefs about the possible benefits of their worrying. The present article suggests that these beliefs emerge from both short-term and long-term experiences with negative reinforcement of the worry process. Elements of treatment that target these beliefs within a general cogn...
In this paper, a view of the nature, purpose, and methods of experimentally controlled between-group therapy outcome research is presented. It is argued that the greatest progress in the development of increasingly useful interventions based on between-group therapy designs will come from (a) viewing such controlled therapy outcome research as basi...
In this paper, a view of the nature, purpose, and methods of experimentally controlled between-group therapy outcome research is presented. It is argued that the greatest progress in the development of increasingly useful interventions based on between-group therapy designs will come from (a) viewing such controlled therapy outcome research as basi...
In this article, we respond to the three critiques of our earlier article about between-groups psychotherapy designs. In the original article, we argued that for between-groups psychotherapy designs, the specificity of the scientific information that we gain is determined by how much is held constant and how specific the factors are that are manipu...
Research on worry during the past 15 years has revealed a remarkable amount of knowledge about this pervasive human phenomenon. Worry involves a predominance of verbal thought activity, functions as atype of cognitive avoidance, and inhibits emotional processing. Worry also produces not only anxious experience but depressive affect as well. Recent...
DSM-IV added an emotional response component to the definition of Criterion A for PTSD. The present study investigated the relationship between retrospective reports of emotional responses (fear, helplessness, and horror) and disrupted emotional responses ("numbing") at the time of a potentially traumatizing event and reports of PTSD symptomatology...
Examination of the streams-of-consciousnesscontent of generalized anxiety disorder, dysphoric, andcontrol participants during neutral and worry periodsrevealed that worrying in general was associated with (a) being less present focused; (b)experiencing elevated levels of negatively valenced,high arousal affect; (c) referencing the immediateenvironm...
